labor%20pain
LABOR PAIN
Labor pain experience is highly individualized and will depend on a woman's emotional, motivational, cognitive, cultural and social circumstances.
There is no other circumstance where it is considered acceptable for a patient to experience severe pain that is amenable to safe intervention while under a physician's care.
The pain felt during the 1st stage of labor originates from the rhythmic contractions of the lower uterine segment and progressive cervical dilation mediated via T10-L1 spinal nerves.
The pain in the 2nd stage of labor is more intense due to stretching of the vagina, vulva and perineum as the fetus descends in the birth canal superimposed by the pain of uterine contractions, and is transmitted through the S2-S4 spinal segments.

Prenatal Counseling on Labor Management

Pain of Parturition

  • Labor pain experience is highly individualized and will depend on a woman’s emotional, motivational, cognitive, cultural and social circumstances
  • There is no other circumstance where it is considered acceptable for a patient to experience severe pain that is amenable to safe intervention while under a physician’s care
  • Pain felt during the 1st stage of labor originates from the rhythmic contractions of the lower uterine segment and progressive cervical dilation mediated via T10-L1 spinal nerves
  • Pain of the 2nd stage of labor is more intense due to stretching of the vagina, vulva and perineum as the fetus descends in the birth canal superimposed by the pain of uterine contractions, and is transmitted through the S2-S4 spinal segments
  • Factors shown to correlate with greater pain during delivery include:
    • Nulliparity, older nulliparas, intravenous (IV) induction/augmentation of labor with Oxytocin, younger maternal age, history of dysmenorrhea, maternal fatigue, dystocia, abnormal position of the fetus and increased fetal or maternal weight

Patient Satisfaction

  • A woman’s sense of satisfaction with her childbirth experience will not necessarily depend on pain relief but on:
    • The amount of support she receives from caregivers
    • The quality of caregiver/patient relationship
    • The amount of participation she had in the decision making during labor and delivery
    • Her expectations
  • There are no standardized approaches to labor pain management
  • The healthcare team can help reduce a woman’s fear about giving birth by providing accurate, precise and relevant information prior to delivery
    • Pain relief options that will be available should be reviewed with the patient and her partner
    • If the woman has certain plans about the type of pain relief she expects, this should be discussed in advance
    • Presence of family members or birth companions may help ease the pain and suffering during labor
  • Labor pain may be decreased in women who have attended childbirth classes and in those who have performed aerobic conditioning exercises during pregnancy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
27 Nov 2017
Transdermal oestradiol added to progesterone reduces menopause-related depression, researchers reported at the annual meeting of The North American Menopause Society in Philadelphia, US.
5 days ago
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.
Shilpa Kolhe, MBBS, MD, MRCOG; Shilpa Deb, MBBS, DGO, MRCOG, 01 Aug 2012

Dysmenorrhoea is a medical condition characterized by severe uterine pain during menstruation manifesting as cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs. The term dysmenorrhoea is derived from the Greek words ‘dys’ meaning difficult, painful or abnormal, ‘meno’ meaning month, and ‘rrhea’ meaning flow. It is commonly divided into primary dysmenorrhoea, where there is no coexistent pathology, and secondary dysmenorrhoea where there is an identifiable pathological condition known to contribute to painful menstruation. Symptoms of primary dysmenorrhoea begin a few hours before the start of menstruation and are often relieved during the first few days of bleeding. The initial onset of primary dysmenorrhoea is usually shortly after menarche (6–12 months), when ovulatory cycles are established. Secondary dysmenorrhoea can also occur at any time after menarche but is most commonly observed in women in their third and fourth decade of life in association with an existing condition.

27 Nov 2017
Chronic hepatitis B virus (HBV) infection is a global problem. Chronic HBV infection is probably the most common maternal infection encountered in Hong Kong, China, and Southeast Asia. In Hong Kong, which is one of the endemic areas, immunisation against HBV was first provided in 1983 to infants born to mothers who were screened positive for hepatitis B surface antigen (HBsAg). Immunisation became widespread since November 1988, but HBsAg-positive mothers are still encountered frequently.1